Title: Spinal Anaesthesia Using Taylors Lumbosacral Approach to Reduce the Incidence and Severity of Hypotension in Patients Undergoing Transuretheral Resection of Prostate

Authors: Dr Kamini Randhawa, Dr Shweta Mahajan, Dr Arti Sharma

 DOI: https://dx.doi.org/10.18535/jmscr/v9i6.10

Abstract

Hypotension are the most common undesired side effects during spinal anaesthesia. Taylor lumbosacral approach of spinal anaesthesia caused less hypotension in patient undergoing TURP.  The purpose of the present study was to compare the incidence and severity of hypotension between a lumbar approaches at L4/5 or Taylor’s lumbosacral approach. 30 patients received SPA by a L4/5 approach and 30 patients by Taylor’s approach. Bupivacaine dose did not differ between groups. Onset of MLSB was faster (3.17+1.020 min vs 7.20+1.215, p < 0.001)  in the lumbar group. Onset of motor block was faster (5.47+1.358 min vs 8.40+0.770) in lumbar group but duration of motor block did not differ between groups. The maximum decrease in mean arterial pressure was also greater in the lumbar group (60% vs. 70%, p value 0.037). SPA with plain bupivacaine using Taylor’s approach was associated with slower onset of MLSB and less hypotension compared to the classical lumbar approach at L4/5.

References

  1. Aidan M O Donnell, Irwin TH Foo MB BChir. Anaesthesia for transuretheral resection of the prostrate. Br J Anaesth 2009; 9(3): 92-6.
  2. Vitalis Mung’ayi, Karen Mbaya, Thikra Sharif, Dorothy Kamya. A randomized controlled trial comparing haemodynamic stability in elderly patients undergoing spinal anaesthesia at L5-S1 versus spinal anaesthesia at L3-L4 at a tertiary African hospital. African health science 2015; 15(2): 466-79.
  3. Rafiqul Islam, Mozaffer Hossain, Quazi Arefin Kabir, Abdul Alim. Paramedian approach for subarachnoid blockade – A marvelous technique having less attention. Journal of BSA 2006; 19: 51-3.
  4. P. Chalapathy, Dr. E. Jayasundaram. Taylors approach is best apporoach to overcome difficulty in lumbar puncture in difficult spinal cases. IORS-JDMS 2016;15-12
  5. Litz, R.J, Brandt, M.; Wiessner, D.; Heller, A.R.; Koch, T. spinal anaesthesia using Taylors lumbosacral approach reducing incidence and severity of hemodynamic side effect in patient undergoing transuretheral surgery. EJA 2006; 23: 114.
  6. Kumkum Gupta, Bhawna Rastogi, Prashant K .Gupta, Avinash Rastogi, Manish Jain and V.P.Singh.Subarachnoid block with Taylors approach for surgery of lower half of body and lower limb:A clinical study. Anesth Essays Res.2012; 6(1): 38-41.

Corresponding Author

Dr Kamini Randhawa

Junior Resident, Department of Anaesthesiology, Indira Gandhi Medical College, Shimla